Speech #1050019473

NMswO HOMES BAR Leoct. I~ot~tUtOVIN LoST RUN(By Rachel L. Swarns) As the health care Industry braces for Fedoral ours that will leave thousands of Immi. grants without Medicaid this all. nursing tomes have begun to mistakenly deny admission to some elderly and sickly legal Immigrants who will not lose their health caverage. Bewildered by the new Federal welfare law and fearfal that Immigrants will dfault on their bills. some health care centers in New York and around the country are asking prospective patients for cItizenship papers Instead of residency papers upon admission. hospital and nursing home administrators say. And while New York State health officials acknowledge that a small group of Immigrants will lose Medicaid as Federal restricton go into effect later this year. they warn that the new practice unfairly denies care to the vast majority who will keep that coverage. But as health c re administrators peer into the faces of their elderly applicants and struggle to interpret the law. some have found it easier to refe all legal lmmigran tthose with green cards but nt cWtIzenshrpthan to figure out who will keep benefits and who will lose them. "its heartbreaking. but were all too tertfled to admit anybody who Is not a citizen." said Sheryl Gemiader. the director of admissions at the Sephardle Home for the Aged in Brooklyn. which now rejects all legal immigrants who need longterm care. "A green card was the ticket in six months ago. but now our attorneys are warning us not to take any chances. The confusion is the unintended consequence of the changes In the Federal welfare laws. which allow states to continue Medicaid to some legal Immigrants while denying coverage to others. New York. along with at lent as other states. plans to continue benefits to poor legal Immigrants who entered the country before Aug. 22 of last year. when President Clinton signed the welfare bill. But those who have arrived since then will generally find themselves Ineligible for Medicald coverage for five years. No one knows how many eligible immlgrants have been turned away from care cantori for the elderly. but health care officials in New York said that dozens had been re. jected in the last month. And adminstrators at public hospitals In Miami and Los Angeles. who are also reporting their first cases. fear the problem will balloon If the law Is not clarfied. stranding Immigrants In hospltal beds neuded by acutecare patients. Already. legal Immigrants too sickly to tme and toe Senile to recognise their children are beginning to languish in hospitals And families who can no longer care for allleg relatives now find themselves overwhelmed with few options. .f this continues. what will we do with these people?" asked Caro Burger. an administrator at Simhurst Bospital Center in Queens as she searehed for a place for an 83yearold legal immigrant from Romania. one of about 20 patients rejected by nursing homes for lak of cItiunship. "Where are they going to go?" Represen ative E. Clay Shaw Jr. a Republia of Florida and the chIer ponsor of the new welfare law. called the situation "worrisome" and said he had never intended to deny care to ellgilhie Immigrants. By law. nursing homes may refuse patients who cannot pay their bills. But Mr. Shaw said be doubted that elderly care centers that receIve Federal funds. In the form of Medicaid payments. had the right to turn away legal immigrants who were eligible for care. "Tberes no question that Its discrimination." he said in an Interview. Mr. Shaw said that care centers needed better guidance from state and Federal health official and that his Congressional committee would provide it. if others did not. "1 can understand their confusion." he said of the nursing homes. "But obviously. some elderly people have fallen through the cracks" Paralyzed by a stroke that left empty spaces in her memory. Ralsa Sinker. a 74yearold legal Immigrant from Ukraine. spent ene month at Huntington Hoispital on Long Island. rejected by one nursing home after another. until a Brooklyn rebabilitation center took her in. Withered by the stomach cancer that has left him maroned at. Elmhurst Bospital Center for two months. Lols Bejarano. 74 and a legal immIgrant from Colombia. has been told not Wo ven hop for a nursing home bed. although he. too. will keep his Medicald coverage. And more than 0 legal Immigrants from China many of them too crippled to walk or brush their thinning hair. recently found themselves stranded with families who could not care for them when a Staten Island retirement home rejected their pleas for placemeat this month. "These families come all the way from Chinatown and beg us to take their elderly relatives. and Ive got to look in their eyes and tell them no." said Clinty Miner. the case manager at the Staten Island home. the Anna &rlka Home for Adelts and Assisted Living Programs. which caters to elderly Asian Patients. "Weve taken these people into our country. ad now when they need help. we have to turn them Away." she sil. "s a horrible feeling. Wed love to take everyone. but Its jist too much of a risk." The confusion over eligibility sters. in part. from the Federal Governments distincion between "qualified" Immigrants. who will keep beneflts. and "nonquallfied" immigrants. who will lose them. In New York State. virtually all legal Imrdgra r. those who arrived before Aug. . are considered qualified. These nonoltizens. who Include legal permanent residents. refugoes and seekers of political asylum. will keep Medicaid. which covers nursing home costs. Even the estimated 87.00 legal immigrants expected to lose supplemental Security Income benefics. the Federal cash payments accepted by retirement homes. will receive state funds to cover their stay. state health officials say. The S.S.L recipients* Medicaid status will be reevaluated. but state officials say the coverage will continue unless the recipients are no longer poor or disabled. Although the State Legislature has not formally pased the welfare law that ineludes this provision. Demorats and Republicans say there is no dispute over the issue. "They should not he turning away this group on the basis that they will be losing Medicaid eligibility. because that will not happen." mid Frances Tarlton. a spokeswoman for the State Department of Health. But a group of about 16.000 timmigrnts. considered "present under color of law." who have been granted temporary residency and revove Government ervices. are expeted to lose both Medicaid insurance and cash benofits beginning in August. And legal ImmigrantA who Arrived on or after Aug. 22 of last year--a group that will Increase over timewill be Ineligible for Medcaid. State officials sid they had tried to make the distinctions clear. But health care adminlstrators for the elderly are still frantically seeking guidance. calling politiclans. reading trade newsletters and viewing Government World Wide Web sites. "Im getting calls from nursing homes and theyre saying. 1 have a legal Immigrant here. What do I dol" said Scott Sandford. director of regulatory affairs for the New York State Health Facilities Association. a trade group that represents 90 nursing fames. "We have been tAling our members. You have to be really careful about someone who is not a cltizen.